Shiny focused Buffy is standing on a tomb, listening to the worms turn in one of the many Sunnydale graveyards as part of her all-new, all-slay commitment to excellence. It appears to be working out: she leaps down and stakes a vamp before it can even clear a grave. But she’s not alone out there this evening: before she can go for the double, Riley whales on and stakes a second fangy attacker. Then Spike attacks the third.

Once this last vampire is, like his predecessors, dust, Spike tries to whip up a little trouble in BuffRileyland. He can’t help it: he’s not a Riley shipper, and that’s how he deals with his pain. But neither of the humans is looking for an argument, even one about whether Riley should be patrolling alone anymore.

(It doesn’t hurt that Riley was very competent and still stronger than your average human when he staked Bachelor Number Two.)

Spike, foolishly, monologues as they walk away: “I will know your blood, Slayer. I will make your neck my chalice and drink deep.” And—as is usual when he gets all pronounce-y—physical comedy ensues. He stumbles into an open grave. Grab a clue, Spike. All that cheap talk is just summoning up the banana peels.

Apres credits, Willow and Buffy are debating French history and the role of vampirekind therein. It’s a scholarly conversation, one that thoroughly delights Willow, and it leads them, naturally enough, to the soon-to-open, under-Giles-management New Improved Boogety Boogety Box. Giles’s investment is already evolving into the official Scooby batcave, becoming a true replacement for the lost lamented Sunnydale High library. And the gang’s all there! Anya’s checking stock, Xander’s building shelves, and Tara thinks the store should do Tarot readings, though she doesn’t believe she has the skills to offer them.

Best of all, Buffy gets a danger room! She’s lavishly grateful to the Scooby guy contingent for building it. Riley jumps all over her, hoping for a test skirmish. Did I mention he’s having an attack of the peppies?

No so Spike. He’s watching TV when there’s a knock at the crypt. It’s Harmony. She’s afraid Buffy is after her and will do anything for shelter. Now she’s officially an aspirant to the Slayer-slaying title, she’s also trying to learn to smoke.

The two of them bat around the prospect of murdering Buffy. He’s still chipped, so Harmony’s the one who would have to do all the heavy killing. Spike agrees to help with the thinking, though.

I am right now imagining that it could have been nifty if Harmony had been able to transform herself into a legitimate Big Bad. Unlikely? Yeah. Hard sell? Totally. Could Joss and Co. have scripted something convincing? I believe they had the core storytelling talent. Then again, could Mercedes McNab have carried a Big Bad role?

We shall never know. Buffy will always have bigger problems than Harmony. Next scene, for example, as Dawn is telling their mother that every kid’s dream is to make the substitute teacher cry, Joyce flakes out, asks who the Hellmouth Dawn thinks she is and then underlines her point with a big old dish-shattering faint.

Buffy and Riley rush to the hospital. Dawn’s waiting, and we meet Ben the intern. At this point, the first time, we probably thought: “That doctor’s got a name! He’s going to die horribly and maybe get turned to a latex-faced creature of the night!”

Ben lent Dawn his stethoscope, which leads to her discovering that Riley has an impressive case of tachycardia and some Initiative-induced nosocomephobia, too. He refuses treatment, claiming his racing pulse is just an unimportant side effect of his having been a military lab rat for Whedon knows how many months. Joyce shows up with an invoice saying “We don’t know what’s wrong with you but it’s probably nothing, or possibly supernatural, please leave all your money behind before you leave.” They all go home.

See? Trying to decide between obsessing about why Mom fainted and obsessing about whether your boyfriend’s heart is about to explode is a way bigger problem than the undead mean girl from your incinerated high school. Buffy goes with the (slightly less unsettling, but more immediate) concern for Riley’s health. What to do? It’s a thorny problem.

Dawn suggests that she say something where the sekrit government listening devices will pick up the gist, and Buffy realizes this is a thoroughly outstanding idea. Does she thank her kid sister? No. But she tries it out, nonetheless. Soon Graham shows up, waving medical assistance at Riley, who fights him off, with bonus beatings for Graham’s two Initiastooges.

Reluctantly, Graham turns to Buffy. He tells her to bundle up Riley—since this is apparently beyond his abilities—and convey him to an operating theater. But Riley’s hiding. Buffy then makes the mistake of asking Spike for help.

What he hears: “Hey, there’s a doctor in town who can de-chippify you!”

So Spike zooms off to the neurology unit, where Graham is officially having a bad episode. He and Harmony grab the Initiadoctor and haul him off to an abandoned medical school to force him to restore Spike’s homicidal mojo.

Buffy doesn’t know that. Down in the cave where she finally finds Riley, she learns he’s afraid she won’t want him anymore, once he’s, you know, even more normal than ever before. She is deeply offended by this arguably true assertion, and tells him that if what she wanted was a monster, she’d be dating Spike.

Hmmmm.

She also points out she’s gonna haul him to the doctor, like it or not. Sadly, of course, the doctor is busy performing brain surgery on Spike under duress. He has no clue how to get the chip out, so he’s just faking it and hoping for the best.

On the face of it, this may seem like a dumb plan, but for once stalling works! BuffRiley show up, the chip’s still implanted, and that’s one saved doctor. (He was named, too, if you care.) Sparmony are forced to run for it. Riley goes under the knife.

The outcome of the surgery is pretty much what Riley fears: he’s a normal guy with a super-girlfriend and more stitches than ever before. When Buffy pecks him on the cheek and rushes off to check on her fainting mom, Graham takes a run at convincing Iowa he should return to the military fold.

Finally, for dessert, we get what looks like a very justified smackdown of Spike for his misbehavior. Buffy comes over to the crypt, all angry and ready to stake him. Spike rips his shirt off and begs her to do it, which leads, as it will, to kissing. She says she wants him. He says he loves her . . .

And then Spike wakes up, realizes just how very much he is, in fact, love’s bitch, and we close on him bargaining with the universe: “No, please, no!”

“Out of my Mind” is one of those stories that is really just a collection of plot points connecting us to narratives in progress. Riley’s meltdown throws a line back to season four, reminding us who he was and what he’s given up; with Graham urging him to get a mission, and Xander gently trying to hint to Buffy that Riley is unhappy (all he manages to do is confuse Anya, in a very cute way) we can see his future coming together. Spike’s doctor-menacing antics are similar. They are a consequence of the Initiative’s activities in the previous year—and, of course, the chip is really the thing that gives him continued access to Team Slay. This is suddenly handy, now that he’s realized he’s in love with Buffy.

Finally, all this medical action introduces us to Ben, planting the seeds of his connection to Dawn. And at the center of it, tying it all together, is Joyce’s collapse, that first painful step down a very sad road.

Next: Where Little Siblings Come From

A.M. Dellamonica has kaboodles of fiction up here on Tor.com! Her ‘baby werewolf has two mommies,’ story, “The Cage,” made the Locus Recommended Reading List for 2010. There’s also “Among the Silvering Herd,” the first of a series of stories called The Gales.